Provider Demographics
NPI:1104938117
Name:SCHRAMM DRUG INC
Entity type:Organization
Organization Name:SCHRAMM DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:505-257-3882
Mailing Address - Street 1:721 MECHEM DR
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-6911
Mailing Address - Country:US
Mailing Address - Phone:505-257-3882
Mailing Address - Fax:505-257-3552
Practice Address - Street 1:721 MECHEM DR
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6911
Practice Address - Country:US
Practice Address - Phone:505-257-3882
Practice Address - Fax:505-257-3552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
NMPH00002877332B00000X
NM2877333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
3208887OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NM59911Medicaid
NM3208887OtherNABP
NM4068780001Medicare NSC